Golden Victory Medical Internal Medicine

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GOLDEN VICTORY MEDICAL INTERNAL MEDICINE

Practice address

2870 S Maryland Pkwy Ste 200
Las Vegas, NV 89109-1580

Phone

(702) 703-1950

NPI assigned

Jul 11, 2022

Last updated

Nov 21, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elizabeth Brown

Title

Aprn/Owner

Phone

(952) 923-7256

Specialties & licenses 3

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668988800000",
    "number": "1447984976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2870 S MARYLAND PKWY STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891091580",
            "telephone_number": "702-703-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2870 S MARYLAND PKWY STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891091580",
            "telephone_number": "702-703-1950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1603 W 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Stillwater",
            "state": "OK",
            "postal_code": "740745202",
            "country_code": "US",
            "telephone_number": "405-379-0002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GOLDEN VICTORY MEDICAL INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "APRN/OWNER",
        "authorized_official_telephone_number": "952-923-7256"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.